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The process of genetic screening has evolved from a simple notation of maternal age to a complex algorithm incorporating age, maternal serum screening, and sonographic findings. The extent to which each of these variables should contribute to the overall screening result is much debated and deserves continued research. It is clear that maternal age provides useful information when used as part of this equation but should not represent the sole screening modality. The use of genetic screening in a general population should be examined in terms of cost effectiveness without sacrificing patient preference and autonomy.

*Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Medical University of South Carolina, Charleston, South Carolina;

†Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Virginia, Charlottesville, Virginia